These are the 10 worst U.S. states for quality of life

The job market may have cooled a bit, but there are still far more job openings nationwide than there are people available to fill them. That means qualified workers are still a precious commodity.

So, companies seeking to attract great employees like to set up shop in states that offer a great quality of life. While some states are more than happy to oblige, these are not those states. They are America’s worst states to live and work in. 

Each year, CNBC’s America’s Top States for Business study considers quality of life among ten categories of competitiveness used to rank the states. Under this year’s methodology, the Quality of Life category counts for 13% of a state’s overall score. 

We score each state on multiple livability factors including crime rates, health care, air quality and child care. We also consider worker protections, and legal safeguards against discrimination of all kinds. And, we look at personal freedom including reproductive rights. 

In these ten states, the welcome mat has more than a few holes in it. 

10. Arizona 

Members of Arizona for Abortion Access, the ballot initiative to enshrine abortion rights in the Arizona State Constitution, hold a press conference and protest condemning Arizona House Republicans and the 1864 abortion ban during a recess from a legislative session at the Arizona House of Representatives on April 17, 2024 in Phoenix, Arizona. 

Rebecca Noble | Getty Images

Because everyone has their own opinion about the weather, we don’t include it in our Quality of Life rankings. That means Arizona reaches the bottom tier without even considering the sweltering heat. We do, however, consider air quality, and the state’s rising temperatures are contributing to some of the worst ozone pollution in the nation, according to the American Lung Association. 

The Grand Canyon State also has growing gaps in health care, with fewer than two staffed hospital beds per 1,000 people, according to the American Hospital Association. 

In May, Democratic Gov. Katie Hobbs signed a repeal of the near-total abortion ban passed in 1864, before Arizona was a state. But that still left the state with a 15-week ban. And a quirk in the state constitution could allow the 1864 ban to go back into effect, if only briefly, this fall. 

2024 Quality of Life Score: 119 out of 325 Points (Top States Grade: D-)

Strengths: Crime, Voting Rights, Worker Protections

Weaknesses: Air Quality, Reproductive Rights, Health Care  

9. Kansas 

Thomas Barwick | Digitalvision | Getty Images

8. Louisiana

Police officers work at the scene of a shooting that occured during the Krewe of Bacchus parade in New Orleans, February 19, 2023. 

Chandan Khanna | AFP | Getty Images

7. Missouri

St. Louis County Prosecutor Wesley Bell listens to a concerned voter after casting his ballot on November 3, 2020 outside the St. Louis County Board of Elections in St. Ann, Missouri.

Michael B. Thomas | Getty Images

6. Tennessee 

Educators and various organizations from across the state of Tennessee march to the Amazon headquarters in downtown Nashville in protest of Governor Bill Lee’s school voucher program on March 12, 2024 in Nashville, Tennessee. 

Seth Herald  | Getty Images

The Tennessee Bureau of Investigation reports that violent crime in the Volunteer State is declining, including a nearly 9% drop in the murder rate in 2022. But it is still among the most violent states in the nation, according to FBI crime statistics. 

The Human Rights Campaign alleges Tennessee lawmakers unleashed “a tsunami of discriminatory legislation” in 2024, including a law signed by Republican Gov. Bill Lee in April that forbids the state social services department from seeking to place LGBTQ+ foster children in supportive homes. Another law clears the way for the state to abolish its independent human rights commission, folding it into the partisan Attorney General’s office. 

2024 Quality of Life Score: 96 out of 325 points (Top States Grade: F)

Strengths: Child Care, Air Quality

Weaknesses: Crime, Inclusiveness, Health Care

5. Arkansas

Kali9 | E+ | Getty Images

4. Oklahoma 

Dr. Franz Theard consults a woman seeking abortion from Oklahoma in his clinic, Womens Reproductive Clinic, a provider of abortions in Santa Teresa, New Mexico on May 7, 2022. Paul Ratje/The Washington Post via Getty Images

Paul Ratje | The Washington Post | Getty Images

Oklahoma’s abortion ban, triggered by the Supreme Court’s 2022 Dobbs decision, is among the most restrictive in the nation, according to the Guttmacher Institute. It prohibits abortions at any stage of pregnancy, except in cases of rape or incest, or if the procedure is necessary to save the life of the mother. Oklahomans have the nation’s third-highest obesity rate and the third-lowest rate of physical exercise. That helps make the Sooner State among America’s least healthy. 

2024 Quality of Life Score: 85 out of 325 points (Top States Grade: F)

Strength: Air Quality

Weaknesses: Reproductive Rights, Health, Worker Protections, Voting Rights 

3. Alabama 

Voters enter a polling location to cast their ballots in the state’s primary on March 5, 2024 in Oxford, Alabama. 15 States and one U.S. 

Elijah Nouvelage | Getty Images

2. Indiana 

Solstock | E+ | Getty Images

1. Texas 

Darwin Varela is carried into the Fort Duncan Regional Medical Center after suffering from dehydration on July 18, 2023 in Eagle Pass, Texas. 

Brandon Bell | Getty Images

Yes, we know. People are moving to the Lone Star State in droves. Some 220,000 educated workers moved there in 2022 alone, according to the Census Bureau. So how could we possibly score Texas at the bottom for Quality of Life? The fact is that people move to a state for any number of reasons. The ones arriving in Texas are encountering some serious livability issues, based on the data. 

Take something as basic as health care. Texas ranks near the bottom in primary care providers per 100,000 residents at 182, according to the United Health Foundation. According to The Commonwealth Fund, Texas leads the nation — by far — in residents without health insurance, and a staggering 19% of all people with a credit score in Texas have medical debt that has gone to collections.

Those new Texans are also finding few protections in the law. Texas is another state with no public accommodation law barring discrimination against non-disabled people; it has passed a barrage of laws targeting the LGBTQ+ community; and its abortion ban is the strictest in the nation. Also, if any of those new Texas residents lose their jobs, state unemployment benefits cover less than 10% of the average cost of living, according to Oxfam America. 

Might Texas’ restrictive policies trigger a backlash? There are some anecdotal accounts of people leaving the state over its abortion ban and its anti-LGBTQ+ laws. But for now, statistically speaking, people keep pouring into the state with America’s worst quality of life. 

2024 Quality of Life Score: 75 out of 325 points (Top States Grade: F)

Strength: Air Quality

Weaknesses: Reproductive Rights, Health Care, Voting Rights, Inclusiveness, Worker Protections

 

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